The outcomes of newly diagnosed elderly multiple myeloma patients treated at a single U.S. institution.

Abstract

Improvements in the outcomes of elderly multiple myeloma (MM) patients have lagged behind those of transplant‐eligible patients, likely due in part to the use of less efficacious melphalan‐containing regimens. To date, there are very limited data for the outcomes of elderly MM patients in the United States (US), particularly for novel agent‐containing triplet regimens. In this retrospective study at a single U.S. institution, the outcomes of 117 consecutive newly diagnosed, symptomatic MM patients over the age of 70 were evaluated. The median age was 75 years (range 70–95) with significant baseline comorbidities including 36% cardiac and 20% renal (CrCl < 30 mL/min). The median follow‐up was 43 months and the median number of lines of therapy during the study period was 2 (1–7). Eighty‐six patients (83%) received non‐melphalan doublet, triplet, or quadruplet initial therapy, most with significant planned dose attenuations. For those treated with dose‐attenuated RVD (n = 34), the outcomes were particularly impressive with overall response rate (ORR), complete remission and very good partial remission (CR + VGPR), and progression‐free survival (PFS) of 94%, 65%, and 36 months, respectively, and overall survival (OS) not reached. The PFS with RVD was significantly greater than that of all other regimens (P = 0.030), including RD.